Severe Blistering One Year Post-Skin Grafting: What to Do?

It has been a year since I underwent a skin graft surgery, but recently I have developed severe blisters?

Hello Doctor, about a year ago I had a skin graft on my left leg, from above the knee to about one-third of my thigh, due to a car accident.
The original injury has healed well, and my knee rehabilitation is progressing positively.
However, about a week ago, I suddenly started developing blisters on the skin graft and surrounding area.
I promptly returned to my original doctor, but since they are currently on leave for further training, another physician examined me and prescribed medication.
Unfortunately, the blistering has not improved and has actually worsened.
In the past two days, my knee has started to swell, and I have noticed signs of scar contracture.
I am very concerned about the possibility of the wound becoming malignant or infected, but I am unsure of what to do next.
I would greatly appreciate your guidance.
Thank you very much.

Xiao Bei, 30~39 year old female. Ask Date: 2016/10/13

Dr. Hong Ximing reply Orthopedics

It has been a year since the skin graft surgery, and the scar tissue has stabilized.
However, if blisters and contractures have reappeared, it is advisable to consult a plastic surgeon or dermatologist to determine if there is any degeneration of the scar tissue.

Reply Date: 2016/10/13

More Info

Severe blistering one year post-skin grafting can be concerning, especially when accompanied by swelling and changes in the appearance of the grafted area. It is essential to address these symptoms promptly to prevent complications such as infection or further skin damage.

Firstly, it is important to understand that skin grafts can sometimes have different healing trajectories compared to normal skin. While many grafts heal well, some may develop complications like blistering, especially if there is friction, moisture, or irritation in the area. The fact that you are experiencing blistering and swelling a year after the graft suggests that there may be an underlying issue that needs to be addressed.

Given that you have already sought medical attention but have not seen improvement, it may be beneficial to seek a second opinion from another dermatologist or a plastic surgeon who specializes in post-graft care. They can provide a thorough examination and may recommend additional treatments or interventions.
In the meantime, here are some general recommendations to manage your symptoms:
1. Keep the Area Clean and Dry: Ensure that the grafted area is kept clean to prevent infection. Use mild soap and water to gently cleanse the area, and pat it dry with a clean towel.

2. Avoid Irritants: Be cautious about what comes into contact with the grafted skin. Avoid tight clothing or anything that may rub against the area, as this can exacerbate blistering.

3. Moisturize: Applying a gentle, hypoallergenic moisturizer can help keep the skin hydrated and may reduce irritation. However, avoid heavy ointments that could trap moisture and lead to further blistering.

4. Monitor for Signs of Infection: Keep an eye on the area for any signs of infection, such as increased redness, warmth, pus, or fever. If you notice any of these symptoms, seek medical attention immediately.

5. Follow-Up Care: Since your original physician is on leave, it is crucial to find another healthcare provider who can monitor your condition closely. They may want to perform a biopsy or other diagnostic tests to rule out any serious complications.

6. Consider Compression Garments: If the area is prone to swelling, your doctor may recommend wearing a compression garment to help reduce swelling and support the healing process.

7. Avoid Sun Exposure: Protect the grafted area from sun exposure, as UV rays can damage healing skin and lead to pigmentation changes. Use a broad-spectrum sunscreen with a high SPF when outdoors.

8. Pain Management: If you are experiencing discomfort, over-the-counter pain relievers may help. However, consult with your healthcare provider before taking any medication.

In conclusion, while blistering and swelling can occur post-skin graft, it is crucial to address these symptoms with the help of a qualified healthcare provider. Prompt evaluation and appropriate management can help prevent complications and promote healing. Remember to advocate for your health and seek further opinions if you feel your concerns are not being adequately addressed.

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